Evidence map›Paper›PMID 36282074›Full record

Observational studyCardiology2022

Vernakalant for Cardioversion of Recent-Onset Atrial Fibrillation in the Emergency Department: The SPECTRUM Study.

Johan-Emil Bager, Alfonso Martín, José Carbajosa Dalmau, Alexander Simon, José L Merino, Beate Ritz, Juha E K Hartikainen

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 4 countries.

Johan-Emil BagerDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Alfonso MartínEmergency Department, University Hospital of Móstoles, Madrid, Spain.
José Carbajosa DalmauEmergency Department, General University Hospital of Alicante, Alicante, Spain.
Alexander SimonDepartment of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
José L MerinoDepartment of Cardiology, La Paz University Hospital, IDIPAZ, Universidad Autónoma de Madrid, Madrid, Spain.
Beate RitzMedical Information Department, ADVANZ PHARMA Switzerland Sàrl, Geneva, Switzerland.
Juha E K HartikainenHeart Center Department, Kuopio University Hospital, Kuopio, Finland.
Hospital General Universitario de Alicante Doctor Balmis · ESHospital La Paz Institute for Health Research · ESHospital Universitario de Móstoles · ESMedical University of Vienna · ATSahlgrenska University Hospital · SEUniversity of Eastern Finland · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIntravenous vernakalant is a therapeutic option for symptomatic, recent-onset atrial fibrillation (AF). This secondary analysis from the large SPECTRUM study assessed the safety and effectiveness of vernakalant when used in the emergency department setting (ED group) or in an inpatient hospital setting (non-ED group).

methodsThis post hoc analysis of the international, observational, post-authorization SPECTRUM study included 1,289 and 720 recent-onset AF episodes in adults in the ED and non-ED groups, respectively. Safety endpoints included the evaluation of pre-defined health outcomes of interest (HOIs) and other serious adverse events (SAEs) during vernakalant treatment and during the first 24 h after the last infusion. Effectiveness endpoints comprised the rate of successful vernakalant cardioversion, the time from the start of the vernakalant infusion to cardioversion, and the length of hospital stay. Data were analysed using descriptive statistics.

resultsThe safety profile of vernakalant was similar in the ED and non-ED groups. In the ED group, 12 pre-defined HOIs were reported in 11 patients (0.9%); all but one occurred within 2 h after start of the first infusion. These events comprised nine significant bradycardia cases, of which one was associated with transient hypotension and three with sinus arrest, and 2 cases of atrial flutter with 1:1 conduction. Five other SAEs were reported. All patients with vernakalant-related events recovered without sequelae. No Torsade de Pointes, ventricular fibrillation, or deaths occurred. Successful cardioversion was reported in 67.8% (95% confidence interval: 65.2-70.4) and 66.4% (62.5-70.1) of episodes, with a median time to conversion of 11.0 and 10.0 min in the ED and non-ED groups, respectively. Patients had a median length of hospital stay of 7.4 h and 17.1 h in the ED and non-ED groups, respectively.

conclusionIntravenous vernakalant was well tolerated with similar cardioversion rates in patients treated in the ED or non-ED setting and does not require admission to a coronary care unit or intensive care unit. First-line treatment with vernakalant could allow an early discharge in patients with recent-onset AF treated in the ED.

Indexed as

Atrial FibrillationAdultAnisolesAnti-Arrhythmia AgentsElectric CountershockEmergency Service, HospitalHumansPyrrolidinesTreatment OutcomeAnisolesAnti-Arrhythmia AgentsPyrrolidinesvernakalantAntiarrhythmic drugsAtrial fibrillationEmergency departmentSafetyVernakalant

Identifiers

PMID36282074
PMCPMC9808723
OpenAlexW4307232498

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.